Veterans with daytime sleepiness face elevated odds for mortality
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Key takeaways:
- As veterans aged, the odds for mortality with a high Epworth Sleepiness Scale score increased.
- Researchers mined Epworth Sleepiness Scale data using natural language processing.
SAN DIEGO — Veterans with high vs. low scores on the Epworth Sleepiness Scale faced a heightened likelihood for all-cause mortality, according to research presented at the American Thoracic Society International Conference.
In this study, Arash C. Maghsoudi, PhD, data scientist at Baylor College of Medicine, and colleagues evaluated 558,796 adults (mean age, 55.1 years; 90.5% men; mean BMI, 32.7 kg/m2) in the Veterans Health Administration from 1999 to 2022 who had polysomnography data or home sleep apnea visits to find out the relationship between excessive daytime sleepiness and all-cause mortality.
Researchers determined the presence of excessive daytime sleepiness through Epworth Sleepiness Scale (ESS) scores, in which a higher score (11-24 points) rather than a lower score (0-10 points) meant more daytime sleepiness.
Notably, veterans were grouped based on the first ESS score in their health records, and this information was collected via a natural language processing method developed by the researchers.
Comparing this method with 470 manually annotated patient’s notes revealed that the natural language processing method had high accuracy of ESS detection (97%) and ESS information extraction (96%).
Following adjustment for several variables (age, gender, BMI, race, ethnicity and Charlson Comorbidity Index), researchers observed heightened odds for mortality among veterans with a high vs. low ESS score (adjusted OR = 1.18; 95% CI, 1.16-1.2).
As age went up, so did the adjusted odds for mortality with a high ESS score. Veterans aged between 50 and 60 years with a high vs. low ESS score had a 12% (aOR = 1.12; 95% CI, 1.09-1.16) higher likelihood for death. This likelihood increased slightly between the ages of 60 and 70 (aOR = 1.14; 95% CI, 1.12-1.17), and then rose higher between the ages of 70 and 80 (aOR = 1.34; 95% CI, 1.29-1.38) and at 80 years and older (aOR = 1.5; 95% CI, 1.12-1.17).
“These results emphasize the importance of recognizing and addressing [excessive daytime sleepiness], particularly among elderly veterans, as it may serve as a valuable marker for predicting mortality,” Maghsoudi and colleagues wrote.